South Counties Pediatric Critical Care Medical Group

LBN: South Counties Pediatric Critical Care Medical Group
South Counties Pediatric Critical Care Medical Group is an health care organization with primary practice located at 17100 Euclid St Attn: Picu, Fountain Valley CA 92708-4004. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Pulmonology. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is the primary health care specialty. South Counties Pediatric Critical Care Medical Group can be contacted via phone (714) 966-7253, or through Reda, Zacharia via phone (714) 966-7253.

Contact Information

Primary practice address
17100 Euclid St Attn: Picu Fountain Valley CA 92708-4004
Phone: (714) 966-7253
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Reda, Zacharia Doctor of Medicine (MD)
Phone: (714) 966-7253

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X

Profile Details

NPI number 1609853688
LBN Legal business name South Counties Pediatric Critical Care Medical Group
DBA Doing business as
Authorized official Reda, Zacharia Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 29th, 2005
Last updated May 28th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609853688 NPPES
California MEDICAID ZZZ57330Z

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